Inter-Sectoral Collaboration in Municipal Health Centres: A Multi-Site Qualitative Study of Supporting Organizational Elements and Individual Drivers

Marius Brostrøm Kousgaard; Christian Elling Scheele; Karsten Vrangbæk

doi:10.5334/ijic.4196

Figures & Tables

Table 1

Interview respondents.

Health centre	From general practice	From the municipalities
Health centre A	One GP (out of one)	One nurse (out of three) Health centre coordinator
Health centre B	Two GPs (out of two)	Two consultants from prevention services Health centre coordinator Leader of nurse home care team Leader of dementia team Leader of training team
Health centre C	Two GPs (out of four)	One physiotherapist (out of two) Two health centre nurses (out of six) Executive administrator of Social Services
Health centre D	One GP (out of three) One GP secretary (out of two)	One physiotherapist (out of three) Two nurses (out of five) Executive administrator of Health and Disease Prevention Executive administrator of Elderly and Health

Table 2

Municipal visions and expectations for the health centres in relation to collaboration.

Health centre*	Visions, goals and expectations
Health centre A	Secure “knowledge sharing” and “good collaboration” between providers Utilize resources across providers “Many aspects have to be clarified when staff and tasks are coordinated and potentially placed closer to each other. This development work has begun in some areas and will be extended so that all actors can find optimal cooperative relations to the benefit of citizens and the coherency of the relevant services”
Health centre B and Health centre C	“Collaboration across professional groups will be facilitated by the physical frames and by arranging the operations of the health centre so that an organizational basis is created for collaboration across sectors and professional groups”. Collaboration between general practitioners and home care services can be extended with a focus on “the elderly, chronically ill, and mentally ill patients” The health centre will create “improved opportunities for round table discussions, and network- and theme meetings with representatives from general practice and the municipalities”. The health centre will “try out new cross-professional and cross-sectoral forms of collaboration…” “Grouping together a number of professional groups in the same health centre [will] create better conditions for collaboration in relation to the more complex patient groups which typically require much coordination and planning. Some of the existing barriers for collaborating across professional groups and sectors are expected to be undermined as the professionals will find each other within reach” “… to make local agreements with general practitioners within the health centre, which can facilitate the [forms of] collaboration that the existing conditions in the general agreement do not enable. Under these conditions it will be easier and more natural to engage in a collaboration on reaching goals for the specific patient or patient group”
Health centre D	“The goal is to co-locate regional and municipal services thereby creating a synergy effect” “Grouping together a number of professional groups in the same health centre [will] create better conditions for collaboration in relation to the more complex patient groups which typically require much coordination and planning. Some of the existing barriers for collaborating across professional groups and sectors are expected to be undermined as the professionals will find each other within reach” “… to make local agreements with general practitioners within the health centre, which can facilitate the [forms of] collaboration that the existing conditions in the general agreement do not enable. Under these conditions it will be easier and more natural to engage in a collaboration on reaching goals for the specific patient or patient group” “Collaboration between the general practitioners and home care services will be extended in relation to the elderly patients since [the health centre] will improve opportunities for conducting network- and theme meetings with representatives from general practice and the municipalities” “…develop and test more integrated and coherent [health and social] services and create a work environment that promotes collaboration […] in relation to individual patient pathways”

[i] * Several of the statements on visions and goals were identical in the project descriptions although the health centres were located in different municipalities. This reflects the involvement of the region in drafting the project descriptions.

Table 3

The expectations to health centre coordinators in relation to cross-sectoral collaboration.

Health centre

Expectations to coordinators as formulated in job postings

Health centre A

“Maintaining the daily operation of the buildings; promote the health centre externally; define the direction in which the health centre should develop; involve tenants in the development of the health centre; contribute to create synergy between tenants; solve ad-hoc tasks for the municipal unit for Health and Disease Prevention”

Health centre B

“…implement new accelerated [patient] workflows that are professionally sustainable”
“promote communication between general practice and municipal [health professionals] in order to avoid misunderstandings that can result in unintended events…“
“analyse one-way and to-way communication between general practitioners and [municipal health] professionals [as]… basis for establishing local cross sectoral agreements concerning digital and telephonic communication;
“coordinate specially themed one-day seminars for general practice and municipal employees.”

Inter-Sectoral Collaboration in Municipal Health Centres: A Multi-Site Qualitative Study of Supporting Organizational Elements and Individual Drivers

Figures & Tables

Table 1

Table 2

Table 3

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